THE ROLE OF OXIDATIVE STRESS IN THE DEVELOPMENT OF INTRAHEPATIC CHOLESTASIS OF PREGNANCY AND ITS OBSTETRIC AND PERINATAL COMPLICATIONS

Objective. To determine the significance of oxidative stress in the pathogenesis of obstetric and perinatal complications in pregnant women with different course of intrahepatic cholestasis (IHC). Material and methods. 59 women with IHC of pregnancy and 30 patients without IHC were examined. The total concentration of nitrite and nitrate ions and thiobarbituric reactive substances (TBARS) in the blood serum of women with IHC was determined, their prognostic significance as predictors of maternal and perinatal complications was analyzed. Results. IHC is accompanied by the development of oxidative stress (Р<0.0001) and endothelial dysfunction (Р(U)=0.013). Determination of the concentration of TBARS in the blood serum of women with IHC allows predicting meconium staining of amniotic fluid (TBARS>17.64 µmol/l, Se=75.0%, Sp=84.3%; AUC=0.820; 95% CI 0,698- 0,908; p=0.0007), preterm labour with a symptomatic course of IHC (TBARS>14.25 µmol/l, Se=100.0%, Sp=71.4%; AUC=0.875; 95% CI 0.635-0.979; p=0.002) and the development of respiratory distress-syndrome in children born to patients with IHC (TBARS>17.32 µmol/l, Se=71.4 %, Sp=75.6%; AUC=0.775; 95% CI 0.648-0.874; p=0.0005). Conclusion. Oxidative stress is an essential link in the pathogenesis of IHC and its obstetric and perinatal complications.